Yesterday, the Centers for Disease Control and Prevention released the results of a study entitled “2009 Pandemic Influenza A (H1N1) Virus Infections: Chicago, Illinois, April-July 2009.”

In a report Rush Limbaugh criticized on the air, Mike Stobbe of the Associated Press (“Swine flu sends more blacks, Hispanics to hospital”) irresponsibly framed CDC’s results in racial terms, and then used them as evidence of health care system “inequities.”

By contrast, Julie Steenhuysen of Reuters (“In Chicago, swine flu hit children hardest”) went right to the study’s key finding, namely that H1N1 appears to be more likely to affect children compared to other flu viruses, which have tended to hit the elderly harder.

The opening paragraphs of Steenhuysen’s work makes you wonder how the AP and Stobbe could have looked at the same CDC study and not have done anything with its critical age-based finding:

Swine flu infected 14 times as many children as adults over 60 in Chicago, city health department officials reported on Thursday in one of the first detailed looks at the new pandemic virus.

No children have died, but the officials said their analysis suggests that prevention efforts should focus on children.

In many ways, the new H1N1 flu virus acted like the typical seasonal flu in Chicago, causing fever, cough and sore throats for most people, said Dr. Susan Gerber, chief medical officer at the Chicago Department of Public Health.

“What was different was that younger age groups seemed to be getting it more often than older age groups,” said Gerber, who reported on the city’s swine flu cases in the U.S. Centers for Disease Control and Prevention’s weekly report on death and disease.

“Our median age for all of the cases reported to the Chicago Health Department was 12 years old. That’s obviously a younger age,” Gerber said in a telephone interview.

Stobbe didn’t just bury the lede; he didn’t report it, period. The word “children” does not appear anywhere, nor does any other age-related term.

• 25 mln people to be infected with new flu in Japan (Link)
• Japan: 7th death linked to new flu confirmed in Hyogo after 6th in Kagoshima (Link) (Link)
• Health ministry: 20% of population may be infected with new flu (Link) Malaysia

• WHO finds Malaysians have low understanding and poor knowledge of A (H1N1) (Link)
• H1N1: Toddler is victim number 70 (Link) Mexico

• 25 mln people to be infected with new flu in Japan (Link)
• Japan: 7th death linked to new flu confirmed in Hyogo after 6th in Kagoshima (Link) (Link)
• Health ministry: 20% of population may be infected with new flu (Link)

Malaysia

• WHO finds Malaysians have low understanding and poor knowledge of A (H1N1) (Link)
• H1N1: Toddler is victim number 70 (Link)

WASHINGTON (Reuters) – Doctors are reporting a severe form of swine flu that goes straight to the lungs, causing severe illness in otherwise healthy young people and requiring expensive hospital treatment, the World Health Organization said on Friday.

Some countries are reporting that as many as 15 percent of patients infected with the new H1N1 pandemic virus need hospital care, further straining already overburdened healthcare systems, WHO said in an update on the pandemic.

“During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services,” it said.

“Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.”

Earlier, WHO reported that H1N1 had reached epidemic levels in Japan, signaling an early start to what may be a long influenza season this year, and that it was also worsening in tropical regions.

“Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections,” WHO said.

“In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.”

Even though testing has so far raised no “red flags” regarding safety of potential swine flu vaccines, surveys and focus groups show that healthcare workers and members of the public may be leery of being getting shots when supplies become available this fall.

Writing in the BMJ, Dr. Paul K. S. Chan and associates at the Chinese University of Hong Kong note that “in nearly all countries with a (pandemic) preparedness plan, healthcare workers are listed as the priority group for mass vaccination.”

Data from 190 Healthcare Facilities in Nine States from California to Maine

A patient health and safety survey of 190 American hospitals from coast to coast compiled by registered nurses in nine different states finds that a disturbing number of our nation’s healthcare facilities are not prepared for the coming H1N1/swine flu pandemic, according to results released today by the California Nurses Association/National Nurses Organizing Committee.

The data reflects a survey conducted over the past four weeks by RNs in hospitals in Arizona, California, Florida, Illinois, Maine, Minnesota, Nevada, Pennsylvania, and Texas. And it comes just a day after release of a report from the President’s Council of Advisors on Science and Technology predicting nearly 2 million Americans could be hospitalized due to swine flu infections this winter, and as many as 90,000 could die, nearly triple the deaths that occur in a normal flu season.

What the RNs reported are wide gaps in safety gear, infection control training, and post-exposure procedures. Among key findings:

Hospital and public health officials who worry about being deluged this fall by sick and worried well patients fearing H1N1 now have comforting federal guidance on how to re-direct crowds without violating the law. First, jammed hospital emergency departments can set up alternate screening sites elsewhere on campus, with personnel stationed outside the emergency department to log in and redirect patients seeking care to that alternate site. This triage system is acceptable as long as the personnel are qualified physicians, RNs, physician’s assistants or nurses trained to perform such exams. Second, hospitals may set up screening at an off-campus site if it is controlled by the hospital. And hospital and community officials may encourage the public to go to these sites instead of the hospital for screening for influenza-like illness. Third, hospitals and community health officials may encourage the public to go to those sites instead of the hospital for influenza screening. And fourth, the required medical screening exam does not need to be an extensive work-up in every patient’s case. The guidance was issued in a fact sheet distributed to hospitals by the Centers for Medicare and Medicaid Services in response to hospital and agency concerns.

Here is what Gratton Woodson MD recommends. You can download his entire free Home Influenza treatment booklet at the link. Perhaps someone will find this useful.-cottontop

The Flu Treatment Kit

Providing good care to family members and friends sick with influenza is a task that will be easier with a good supply of select over-the-counter medications, some medical equipment, and a few items from the grocery or hardware store. These items form the basis of the Flu Treatment Kit (FTK).

Canada has endured the ravages of SARS and the havoc wreaked by a listeriosis outbreak in recent years. Both episodes exposed the glaring shortcomings in our public health protection systems, notably the inability of federal and provincial authorities to seamlessly share information and resources – and act decisively.

Now, with many worried about the spectre of a future Swine flu pandemic, it’s worth asking if we have learned any of the painful lessons of the past. The evidence suggests we are lagging.

At root, Canada’s chief public health officer, Dr. David Butler-Jones, lacks the autonomy and clout he needs to fulfil his mission to protect the lives of Canadians. Indeed, there’s a very real risk that Canada’s public health watchdog won’t be able to provide a full measure of protection from pandemics and other threats.

Last week, the Canadian Medical Association Journal catalogued some of those gaps, arguing for a “health care czar” to deal with any H1N1 flu pandemic down the road.

Such a czar would go too far; it’s not a good fit in Canada’s complex constitutional setting. But the journal was correct in highlighting a public health gap that must be addressed.

The system’s weakness was painfully apparent in last summer’s bungled listeriosis crisis. Local public health agencies, provincial health ministries and federal health and agriculture officials were all involved in handling that outbreak, but no one assumed full responsibility.

Twenty-two people died. Some might well have been saved if a stronger federal health authority had produced a faster, more coherent response.

BLOOD samples of the patient admitted in Mbale Hospital suspected of having Ebola have been found free of the virus, the Uganda Virus Research Institute has said.

The Ministry of Health spokesperson, Paul Kagwa, yesterday said the ministry was investigating other possible diseases the patient, whose name has been with held, might have.

“He is still in the hospital and he cannot be released until investigations are complete,” Kagwa said.

The man was admitted last week after he was referred from Tororo Hospital with suspected Ebola.

He bled from the mouth, nose, ears and passed blood in his stool and urine, which are all symptoms of the haemorrhagic fever.

On Friday, the director of clinical services, Dr. Kenya Mugisha, said not all bleeding is caused by Ebola.

A medical team was dispatched to Mbale to help handle the situation, Dr. Mugisha said.

He added that the patient was in a stable condition.

The patient’s relatives said he was first treated for malaria in Sudan where he worked as a casual labourer at a construction site.

Ebola has a high death rate. The only way to stop or contain it is through prevention, rapid diagnosis and isolation of suspected cases. The last outbreak of the disease was reported in Bundibugyo in 2007.

The disease killed 16 people out of the 51 cases that were reported.

In the 2000, an Ebola outbreak in Gulu claimed 173 people of the 428 people who were infected.